Tick bites & Lyme diseaseBitten by a tick? Know what to watch for.Most tick bites are harmless. But a spreading rash or a flu-like illness in the weeks after a bite can be Lyme disease, and it is easily treated with antibiotics when it is caught early.Book a GP appointmentCall 07857 761328If someone has a severe headache with a stiff neck, a fit, chest pain, fainting or sudden weakness, call 999.Same & next-day appointmentsRashes checked by a GPAntibiotics when neededYou keep your NHS GPRash check £1201Ticks & Lyme disease2Signs to look for3Removing a tick4Stages & risk5Your appointment6Avoiding bites7Get help now8FAQs Medically reviewed by Dr Muhammad Roslan, MBChB, DGM, MRCGP · GP & Clinical Educator · GMC 7446695OUR GP Dundee · Last reviewed November 2026Seen by a GPRash diagnosed in the roomBlood tests when neededClear advice on what to watch forStart hereTicks, tick bites and Lyme diseaseTicks are tiny spider-like creatures that feed on blood. A few carry bacteria that cause Lyme disease, an infection that is treated with antibiotics.Ticks live in long grass, bracken, woodland and moorland, and also in parks and gardens. They do not jump or fly. They wait on plants and climb onto people and animals that brush past, then attach to the skin and feed for several days. Many bites go unnoticed because ticks are small, often no bigger than a poppy seed, and the bite is usually painless.Lyme disease (Lyme borreliosis) is caused by Borrelia bacteria passed on by an infected tick. Scotland accounts for a large share of UK cases. Most people who are treated promptly recover fully, and it does not spread from person to person.Most bites are harmlessOnly a small proportion of ticks carry Lyme disease, and most bites cause nothing more than a little redness.Quick removal helpsThe longer a tick stays attached, the higher the chance of infection. Check and remove promptly.The rash is the key signA spreading rash at the bite site, days to weeks later, can be diagnosed without a blood test.It is treatableA course of antibiotic tablets, usually for three weeks, clears the infection in most people.Back to top ↑Signs to look forEarly signs of Lyme diseaseWatch the bite and how you feel for about four weeks afterwards. Not everyone gets a rash, and many people never notice the bite.A red rash spreading out from the bite, usually 1 to 4 weeks laterThe rash grows over days, usually bigger than 5 cm and sometimes much largerOften round or oval, and may look like a bull’s-eye with a paler centreRed, purple or bluish, and harder to see on brown or black skinUsually not itchy, hot or painfulCommon places: legs, groin, armpits, waistband, under the breasts, and the head and neck in childrenA flu-like illness: temperature, sweats, headache, tiredness, aching muscles or jointsSometimes several smaller rashes away from the biteA small red bump straight after a bite is normal. A red, itchy or sore patch that appears within hours and fades within two days is a reaction to the bite, not Lyme disease. The Lyme rash usually appears later and keeps spreading.At OUR GPGet a rash or tick bite checkedFor anyone with a spreading rash, flu-like illness or other symptoms after a tick bite.A 30-minute face-to-face appointment to examine the rash, take a history and start treatment if needed.Good to know: blood tests for Lyme disease are often negative early on, so a typical spreading rash is usually treated without waiting for a test.About GP appointments →£12030 minutes face to face · video £110 · phone £60 Book nowBack to top ↑Found a tick?How to remove a tick safelyRemove it as soon as you can. Fine-tipped tweezers or a tick removal tool (a tick twister or tick card) work best.1. Grip close to the skinHold the tick by its head and mouthparts, as close to the skin as possible. Don’t squeeze the swollen body.2. Pull slowly upwardsPull steadily and firmly away from the skin. If you use a tick twister, follow the instructions that come with it.3. Clean the skinWash the bite with soap and water or apply antiseptic, then wash your hands.4. Don’t burn or smother itAvoid matches, petroleum jelly, alcohol or nail varnish. They don’t help and may make the tick release more saliva.5. Note the dateWrite down when and where you were bitten, and take a photo of the bite.6. Keep watch for 4 weeksCheck the area for a spreading rash and look out for flu-like symptoms.Do I need antibiotics after a tick bite? Not usually. If you are well, antibiotics are not routinely recommended just because you were bitten. See a GP if you develop a rash or feel unwell. If a small piece of the mouthparts stays in the skin, leave it to come out naturally, and get it checked if the area becomes hot, swollen or sore.Back to top ↑Stages & riskHow Lyme disease can affect the bodyMost people are diagnosed at the rash stage. If the infection is not treated, it can occasionally spread and cause other problems weeks or months later.StageWhat may happenEarly (days to weeks)A spreading rash at the bite site, sometimes with a flu-like illness, tiredness and achesSpreading (weeks to months)Several rashes; a drooping face (facial palsy); numbness, tingling or shooting nerve pain; headache with a stiff neckHeartRarely, a slow or irregular heartbeat, dizziness, breathlessness or faintingJointsSwelling and pain in one or more joints, often the knee, that may come and goEyes and skinRarely, eye inflammation; in children, a painless blue-red lump on the ear lobe; very late, thin discoloured skin on the hands or feetWho is more likely to be bittenTicks are most active from spring to autumn, but can bite all year. The risk is higher if you:walk, hike, run or camp in the countrysidework outdoors in farming, forestry, gamekeeping or land managementwalk a dog or keep animalsgarden, or let children play in long grassspend time where there are deer or sheepleave a tick attached for longer before removing itHaving Lyme disease once does not make you immune. You can catch it again from another bite, so it is worth keeping up good tick habits.Back to top ↑Your appointmentWhat the GP will doThe aim is to confirm or rule out Lyme disease, start treatment quickly when it is needed, and check for anything else that could explain your symptoms.Ask about the biteWhen and where you were, whether you saw a tick, how long it was attached, any travel abroad, and when symptoms began.Examine the rash and youThe typical Lyme rash is enough to make the diagnosis. No blood test is needed, and treatment can start straight away.Blood tests if there is no rashA blood test looks for antibodies to Lyme disease. It can be negative in the first few weeks, so it may be repeated.Treat and follow upAntibiotic tablets, usually doxycycline or amoxicillin for 21 days. Children, and anyone with nerve, heart or joint symptoms, may be discussed with or referred to a specialist.Back to top ↑Avoiding bitesHow to avoid tick bitesYou don’t need to stay indoors. A few simple habits make a bite much less likely.Cover upLong sleeves and trousers tucked into socks. Light colours make ticks easier to spot.Use a repellentChoose one that works against ticks, such as DEET, and follow the label, especially for children.Stick to pathsKeep away from long grass, bracken and overgrown plants where ticks wait.Check your skinLook over yourself at the end of the day: armpits, groin, waistband, behind the knees and under straps.Check childrenTicks often bite children on the head and neck, so check the scalp and hairline carefully.Clothes and petsBrush off clothes before going indoors, and check dogs so ticks aren’t carried into your home. Tick bites and Lyme diseaseDownload our tick bites and Lyme disease leafletA free two-page guide for patients, families and carers: how to remove a tick, the early signs of Lyme disease, how to avoid bites, and when to get help. Keep it in the car or rucksack for days out.PDF · 2 pages · A4 · 224 KBDownload leaflet (PDF)Open to printBack to top ↑Get help nowWhen it can’t waitCall 999 if someone hasa severe headache with a stiff neck or dislike of bright light · a seizure (fit) · sudden confusion or weakness · chest pain · fainting or a very slow heartbeat · severe breathlessnessContact a GP the same day, or NHS 24 on 111 out of hours, ifa rash is spreading out from a tick bite, you have a flu-like illness in the weeks after a bite or time outdoors, one side of your face droops, you have new numbness, tingling or nerve pain, a swollen painful joint, a racing or irregular heartbeat or dizziness, or the bite becomes hot, swollen and sore.A private appointment is not a substitute for emergency care. If you are unsure, call 999 or NHS 24 on 111.Back to top ↑FAQsCommon questions I’ve been bitten by a tick. Do I need antibiotics?Not usually. If you feel well, antibiotics are not routinely given after a tick bite. Remove the tick, clean the skin and watch for a spreading rash or flu-like symptoms for about four weeks. See a GP if either appears. Do I need a blood test for Lyme disease?Not if you have the typical spreading rash: the GP can diagnose Lyme disease by looking at it. A blood test is used when there is no rash but symptoms suggest Lyme disease. It can be negative early on, so it is sometimes repeated a few weeks later. How long after a bite does the rash appear?Usually 1 to 2 weeks after the bite, but anywhere from a few days to about five weeks. It grows over days and can last several weeks if untreated. Should I keep or test the tick?Testing a tick is not needed to decide on treatment. Diagnosis is based on your symptoms. Taking a photo of the tick and noting the date is more useful. Can I get Lyme disease more than once?Yes. Having it once does not give lasting protection, so keep checking for ticks and see a GP if new symptoms appear after another bite. What if I still feel tired after treatment?Most people recover fully, but tiredness and aches can take weeks or months to settle and don’t always mean the infection is still there. Tell us if symptoms are not improving, or come back, so we can review you and look for other causes.Worried right now?For a severe headache with a stiff neck, a fit, chest pain or fainting, call 999. Out of hours, call NHS 24 on 111.Back to top ↑EvidenceWhere this information comes fromThis page follows UK guidance on preventing, recognising and treating Lyme disease.NICE NG95: Lyme diseaseNICE Clinical Knowledge Summaries: Lyme diseaseNICE CKS: When to suspect Lyme diseaseBMJ Best Practice: Lyme diseaseDermNet: Erythema migrans imagesBack to top ↑Rash or feeling unwell after a tick bite?Book a GP appointment and we will check you over and start treatment if it is needed.Book a GP appointmentWhatsApp 07857 761328This page is general information and is not medical advice or a diagnosis. What’s appropriate is a clinical decision made with a GP at your appointment. OUR GP is a trading name of SRS Health Group Limited, regulated by Healthcare Improvement Scotland. All doctors hold a licence to practise with the General Medical Council. Meet our team. We see patients from Dundee, Angus, Perthshire and Fife. More questions? See our FAQs.